CHARACTERISTICS OF PARAMETERS OF CELLULAR AND HUMORAL IMMUNITY IN VARIOUS TYPES OF ANESTHESIA IN PATIENTS WITH DIABETIC FOOT SYNDROME

Oltiev Usmon Bebitovich, Khamdamov Bakhtiyor Zarifovich*, Sabirov Juraboy Marifbaevich, Rakhimov Abdurasul Sharipovich

ABSTRACT

Background: The choice of the optimal method of anesthesia for diabetic foot syndrome, as well as the study of its effect on the immune system is an important urgent problem. The aim of the study: to study in a comparative aspect the effect of general, epidural and conduction anesthesia on the state of cellular and humoral immunity in patients with diabetic foot syndrome (DFS). Materials and methods of research. 157 patients with diabetic foot syndrome who were on inpatient treatment in the department of purulent surgery of the Bukhara Regional Multidisciplinary Medical Center were examined, who made up 3 groups depending on the use of anesthesia methods: The first group consisted of 52 patients (33.2%) operated under general anesthesia (GA). The second group consisted of 51 (32.4%) patients who underwent epidural anesthesia (EA) during surgical interventions on the lower extremities. The third group consisted of 54 (34.4%) patients who underwent conduction anesthesia-stem blockade (PA). Quantitative study of lymphocytes with CD3, CD4, CD8, CD20 phenotype in peripheral blood was performed and the level of IgG, IgA, IgM in blood serum was determined by ELISA. Results. It was revealed that in patients with DFS there are changes in cellular and humoral immunity: the levels of CD3+, CD4+ cells are sharply reduced, the number of CD20+ lymphocytes is increased. IgA and IgG levels are elevated. Analysis of the studied indicators of the immune system before, intra and postoperative periods revealed that patients who underwent OA had deeper changes in the studied parameters than the initial ones. The indicators were slightly better in patients who underwent EA. Conclusion: In patients who underwent surgery with the use of PA, immunological parameters remained at the level of the initial data. Consequently, the use of PA is more gentle in relation to its effect on the parameters of the immune system.

Keywords: diabetic foot syndrome, types of anesthesia, cellular and humoral immunity.